Individual
LAVONYA ANN MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCMH
Contact information
Practice address
1601 MILLTOWN RD STE 13, WILMINGTON, DE 19808-4084
(302) 683-4938
(302) 417-0418
Mailing address
1601 MILLTOWN RD STE 13, WILMINGTON, DE 19808-4084
(302) 683-4938
(302) 417-0418
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PC-0001009
DE
101YP2500X
Professional Counselor
PC-0001009
DE
101YP2500X
Professional Counselor
PC012774
PA
Other
Enumeration date
06/10/2020
Last updated
01/22/2025
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